Summary of findings 2. Alpha‐blockers compared with placebo for ureteral stones.

Alpha‐blockers compared with placebo for ureteral stones
Patient or population: adult patients presenting with symptoms of ureteral stone disease Setting: single or multicenter Intervention: alpha‐blocker Comparison: placebo
Outcomes	No. of participants (studies) Follow‐up	Quality of the evidence (GRADE)	Relative effect (95% CI)	Anticipated absolute effects* (95% CI)
				Risk with placebo	Risk difference with alpha‐blockers
Stone clearance	5787 (15 RCTs)	⊕⊕⊕⊝ MODERATEa	RR 1.16 (1.07 to 1.25)	Study population
				728 per 1000	116 more per 1000 (51 more to 182 more)
Major adverse events	1650 (10 RCTs)	⊕⊕⊕⊝ MODERATEb	RR 2.09 (1.13 to 3.86)	Study population
				26 per 1000	29 more per 1000 (3 more to 75 more)
Stone expulsion time	3240 (7 RCTs)	⊕⊕⊝⊝ LOWc,d	‐		MD 1.98 lower (3.71 lower to 0.24 lower)
Pain episodes	215 (2 RCTs)	⊕⊕⊝⊝ LOWc,e	‐		MD 0.39 lower (1.07 lower to 0.29 higher)
Dose of diclofenac (mg)	3576 (4 RCTs)	⊕⊕⊝⊝ LOWd,f	‐		MD 126.32 lower (181.73 lower to 70.9 lower)
Hospitalisation	500 (2 RCTs)	⊕⊕⊕⊝ MODERATEe	RR 0.84 (0.48 to 1.47)	Study population
				96 per 1000	15 fewer per 1000 (50 fewer to 45 more)
Surgical intervention	1458 (5 RCTs)	⊕⊕⊕⊕ HIGH	RR 0.93 (0.70 to 1.24)	Study population
				127 per 1000	9 fewer per 1000 (38 fewer to 30 more)
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; MD: mean difference; RCT: randomised controlled trial; RR: risk ratio.
GRADE Working Group grades of evidence. High certainty: We are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect. Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect.

^aDowngraded owing to inconsistency (high heterogeneity with I² of 68%).

^bDowngraded owing to imprecision (wide confidence interval consistent with negligible to substantial harm).

^cDowngraded owing to inconsistency (heterogeneity with I² of 57%).

^dDowngraded owing to imprecision (wide confidence interval; wide confidence interval consistent with large to negligible benefit).

^eDowngraded owing to imprecision (wide confidence interval consistent with no effect and small benefit).

^fDowngraded owing to inconsistency (high heterogeneity with I² of 90%).